# MEIJER STORES LIMITED PARTNERSHIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Meijer Pharmacy \#299
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396280160
- **Authorized official:** JASON BEAUCH R.PH (VP OF PHARMACY MERCHANDISING)
- **Authorized official phone:** (616) 791-3169

## Contact information

- **Practice address:** 2180 S MAIN ST, WEST BEND, WI 53095-5754
- **Practice address phone:** (262) 334-8510
- **Practice address fax:** (626) 306-5165
- **Mailing address:** 2929 WALKER AVE NW, ATTN: MANAGED CARE GOVERNMENT PROGRAMS, GRAND RAPIDS, MI 49544-6402
- **Mailing address phone:** (616) 791-3169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/03/2017
- **Last updated:** 03/28/2017